Other Titles

Specialty Sleeper Impacts on Neonatal Intensive Care Unit Admission for Neonatal Abstinence: Average Length of Stay and Eat, Sleep, Console Sleep Scores [Title Slide]

Abstract

During the COVID-19 pandemic, operational modifications resulted in an increased average length of stay (ALOS) for Neonatal Intensive Care Unit (NICU) infants with Neonatal Abstinence Syndrome (NAS), from 10 days to 30 days, and additional workload for nursing staff. In response an innovative responsive bassinet (SNOO) was introduced into existing Eat, Sleep, Console (ESC) care model with goal to improve sleep while maintaining American Academy of Pediatrics (AAP) Safe Sleep positioning.

A retrospective chart review was conducted on neonates admitted to NICU who received scheduled methadone dosing for NAS from December 2020 to September 2022. Study inclusion criteria was primary diagnosis of NAS, birth gestational age ≥35 weeks, and no co-diagnosis which would contribute to length of stay. SNOO was introduced in November 2021. Neonates were grouped in pre-SNOO (baseline) and post-SNOO (intervention) periods. Outcome measures included ALOS and the number of sleep-related “yes” scores on our ESC Care Tool (indicating poor sleep related to NAS). All statistical analyses were conducted on IBM SPSS Statistics 28. Mann-Whitney analysis completed based on sample size. Satisfaction surveys evaluated nurse satisfaction and time savings at 1-month and 6-months post-SNOO.

A total of 109 infant charts were reviewed. 13 infants (n=11%) fulfilled all inclusion criteria (baseline N=6, intervention N=7). ALOS declined by 17.38% (31.30 baseline; 25.86 intervention, p=0.57), and yes-scores for poor sleep decreased by 41.72% (28.67 baseline; 16.71 intervention, p=0.52). No significant differences based on gender, post-natal age, birth gestational age, length of stay, poor sleep scores, pharmacotherapy days, or “just in time” dosing were found. No other modalities of our preexisting ESC model of care were altered between groups. Satisfaction survey data demonstrated 84% of nurses surveyed at 6-months post-SNOO identified a timesaving’s of 1 to 2 hours per shift or more.

Conclusions: While observed reductions in ALOS and yes-scores were not powered for statistical significance, the addition of SNOO as a non-pharmacologic intervention within ESC care models may lead to improved outcomes. Further, impact of SNOO on nursing workload has the potential to improve care, efficiency, and satisfaction. Future studies should explore SNOO’s impact on NICU NAS admissions when utilized in the Newborn Nursery setting or implications of modeling safe sleep practices for this at-risk population.

Notes

References:

Adrian, A., Newman, S., Mueller, M. and Phillips, S. (2020) 'A Mixed-Methods Study to Investigate Barriers and Enablers to Nurses' Implementation of Nonpharmacological Interventions for Infants With Neonatal Abstinence Syndrome', Adv Neonatal Care, 20(6), pp. 450-463.

Grisham, Lisa M. NNP-BC; Stephen, Meryl M. CCRN; Coykendall, Mary R. RNC-NIC; Kane, Maureen F. NNP-BC; Maurer, Jocelyn A. RNC-NIC; Bader, Mohammed Y. MD. Eat, Sleep, Console Approach: A Family-Centered Model for the Treatment of Neonatal Abstinence Syndrome. Advances in Neonatal Care: April 2019 - Volume 19 - Issue 2 - p 138-144 doi: 10.1097/ANC.0000000000000581

Grossman, M. R., Lipshaw, M. J., Osborn, R. R., & Berkwitt, A. K. (2018). A novel approach to assessing infants with neonatal abstinence syndrome. Hospital Pediatrics, 8(1), 1–6. https://doi.org/10.1542/hpeds.2017-0128

Kocherlakota, P. (2014). Neonatal abstinence syndrome. Pediatrics, 134(2).
https://doi.org/10.1542/peds.2013-3524

Sublett, Juli MSN, RN. Neonatal Abstinence Syndrome: Therapeutic Interventions. MCN, The American Journal of Maternal/Child Nursing: March/April 2013 - Volume 38 - Issue 2 – p 102-107 doi: 10.1097/NMC.0b013e31826e978e

Description

Participants will be able to identify symptoms of Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS) as evaluated using the Eat, Sleep, Console tool.

Participants will be able to identify variations in NAS/NOWS treatment practices.

Participants will be able to identify integration of novel technologies into the NICU setting to support NAS/NOWS treatment.

Author Details

Melinda Pariser-Schmidt, MSN, RNC-NIC, IBCLC

Sigma Membership

Omega Mu, Kappa Tau

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Acute Care, Implementation Science, Neonatal Abstinence Syndrome, Neonatal Intensive Care Unit, NICU

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Download
Click on the above link to access the slide deck.

Share

COinS
 

Impact of a Responsive Bassinet on Neonatal Abstinence Syndrome in the NICU

Seattle, Washington, USA

During the COVID-19 pandemic, operational modifications resulted in an increased average length of stay (ALOS) for Neonatal Intensive Care Unit (NICU) infants with Neonatal Abstinence Syndrome (NAS), from 10 days to 30 days, and additional workload for nursing staff. In response an innovative responsive bassinet (SNOO) was introduced into existing Eat, Sleep, Console (ESC) care model with goal to improve sleep while maintaining American Academy of Pediatrics (AAP) Safe Sleep positioning.

A retrospective chart review was conducted on neonates admitted to NICU who received scheduled methadone dosing for NAS from December 2020 to September 2022. Study inclusion criteria was primary diagnosis of NAS, birth gestational age ≥35 weeks, and no co-diagnosis which would contribute to length of stay. SNOO was introduced in November 2021. Neonates were grouped in pre-SNOO (baseline) and post-SNOO (intervention) periods. Outcome measures included ALOS and the number of sleep-related “yes” scores on our ESC Care Tool (indicating poor sleep related to NAS). All statistical analyses were conducted on IBM SPSS Statistics 28. Mann-Whitney analysis completed based on sample size. Satisfaction surveys evaluated nurse satisfaction and time savings at 1-month and 6-months post-SNOO.

A total of 109 infant charts were reviewed. 13 infants (n=11%) fulfilled all inclusion criteria (baseline N=6, intervention N=7). ALOS declined by 17.38% (31.30 baseline; 25.86 intervention, p=0.57), and yes-scores for poor sleep decreased by 41.72% (28.67 baseline; 16.71 intervention, p=0.52). No significant differences based on gender, post-natal age, birth gestational age, length of stay, poor sleep scores, pharmacotherapy days, or “just in time” dosing were found. No other modalities of our preexisting ESC model of care were altered between groups. Satisfaction survey data demonstrated 84% of nurses surveyed at 6-months post-SNOO identified a timesaving’s of 1 to 2 hours per shift or more.

Conclusions: While observed reductions in ALOS and yes-scores were not powered for statistical significance, the addition of SNOO as a non-pharmacologic intervention within ESC care models may lead to improved outcomes. Further, impact of SNOO on nursing workload has the potential to improve care, efficiency, and satisfaction. Future studies should explore SNOO’s impact on NICU NAS admissions when utilized in the Newborn Nursery setting or implications of modeling safe sleep practices for this at-risk population.